Learning that your cancer has spread, or come back, may be even more devastating than hearing for the first time that you have cancer. It may be hard to take it in – your thoughts may be in complete turmoil, or your mind may go blank. This shock and disbelief can give way to strong, often overwhelming, emotions.

'I don't remember the journey home. It was like a film without any soundtrack – a jumbled mass of meaningless images.'

People often have a sense of loss, or feelings of failure. You may have hoped that you were cured and now find your cancer has come back despite your efforts to overcome it. You may find yourself tearful and feeling low. Some people are stunned and resentful to see life going on as normal around them when their own world is in such turmoil.

Many people are frightened. You may be afraid of the illness itself; the treatment; the effect it may have on your family; symptoms such as pain; or dying.

You may feel very angry – with yourself, or with the doctors and nurses for giving you bad news. You may be angry at fate, feeling that it is so unfair that this should have happened. You may be resentful and frustrated that your immediate plans will be disrupted with tests and treatment, and that your long-term plans have suddenly become uncertain.

Some things may shock you: decisions like ‘Is it worth paying my subscription this year? – I may not be here long‘ or ‘I’d love to buy some new clothes – but will I ever get to wear them?’

Different people have different emotions. Living with the uncertainty that comes with the spread or recurrence of cancer is likely to be physically and emotionally demanding.

If you had hoped that your cancer was cured, it can be very hard to have to make decisions about treatment again, about what to tell your family, friends and people at work, and about what adjustments to make to your home life. There are many sources of help.

'I rarely cried in the early days with the condition but since the secondary sites were confirmed I find I cry more readily, and the release of emotion helps enormously because I get very pent-up.'

• Be aware of how you feel. It’s natural and normal to feel a whole range of powerful emotions when your life is suddenly turned upside-down by illness. There are many ways you can get help to enable you to work through and deal with your emotions.

• If you can, find someone you can talk to about how you feel. This might be a family member or friend, a nurse or other carer, or a religious or spiritual leader. If you feel uncomfortable talking about these things with someone you know, you may prefer to join a support group or to see a counsellor.

• Remind yourself of ways in which you have dealt with other difficult situations in the past. Remember the strengths you had then, and see if you can use them again now.

Services such as Cancerbackup can help in giving support and information at this time.